Global warming intensifies the hydrological cycle by altering the rate of water fluxes to and from the terrestrial surface, resulting in an increase in extreme precipitation events and longer dry spells. Prior hydrological intensification work has largely focused on precipitation without joint consideration of evaporative demand changes and how plants respond to these changes. Informed by state-of-the-art climate models, we examine projected changes in hydrological intensification and its role in complicating water resources management using a framework that accounts for precipitation surplus and evaporative demand. Using a metric that combines the difference between daily precipitation and daily evaporative demand (surplus events) and consecutive days when evaporative demand exceeds precipitation (deficit time), we show that, globally, surplus events will become larger (+11.5% and +18.5% for moderate and high emission scenarios, respectively) and the duration between them longer (+5.1%; +9.6%) by the end of the century, with the largest changes in the northern latitudes. The intra-annual occurrence of these extremes will stress existing water management infrastructure in major river basins, where over one third of years during 2070–2100 under a moderate emissions scenario will be hydrologically intense (large intra-annual increases in surplus intensity and deficit time), tripling that of the historical baseline. Larger increases in hydrologically intense years are found in basins with large reservoir capacity (e.g., Amazon, Congo, and Danube River Basins), which have significant populations, irrigate considerable farmland, and support threatened and endangered aquatic species. Incorporating flexibility into water resource infrastructure and management will be paramount with continued hydrological intensification.